What is Abuse and Neglect?

Frequently, children who are the victims of abuse have warning signs ahead of time. Many will have a minor injury that is a warning that something worse may happen.

Paying attention to these injuries in young children who aren’t crawling or able to cause the injury to themselves can be key to identifying children who may be at risk for more significant injuries.  These injuries are generally minor but unexplained. 

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Signs and Warnings

How to Recognize Child Abuse
and Neglect

In children, some patterns of bruising and injury if caught early will help prevent the children from being injured more severely. Two validated clinical rules that help screen for potential child abuse and are commonly used are: FACESp and TEN-4

By law, everyone in Texas is a mandated reporter. Professionals may not delegate the duty to report to anyone else. The mandatory reporting requirement applies without exception to an individual whose personal communications may otherwise be privileged, including attorneys, clergy, medical professionals, social workers, and mental health professionals.

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  • Frenulum tear
  • Bruising of the angle of the jaw
  • Bruising of the cheeks (fleshy)
  • Eyelid bruising
  • Subconjunctival hemorrhage (outside of birth)
  • Patterned bruising


  • Used to help differentiate between bruises that are more commonly caused by accidental and inflicted injuries
  • The TEN-4 regions:
    • Torso
    • Ears
    • Neck
    • (In children < 4 years)
  • Bruising to these areas and ANY bruising to a child less than 4 months are high probability for abuse

Who do I report child abuse or neglect to?

(Call 911 if the person is in immediate danger)

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Call the Texas DFPS Abuse Hotline toll-free 24 hours a day, 7 days a week, nationwide.
Report online if victim is not in immediate danger.
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